Biomedical subjects
Publications and source records attributed to A Pinckers.
Examination of a great number of patients resulted in the depth localisation theory. The combination of this theory with the fixation-eccentrisation theory is clinically useful: acquired colour vision defects can be subdivided by the fixation mode and by signs of receptor damage. There are indications that in multiple sclerosis the slowly progressive cases present with more receptor damage than the acute cases.
The Berson test for blue cone monochromatism discriminates X-linked blue cone monochromatism from achromatopsia but not from X-linked progressive c dystrophy.
With the New Color Test (NCT) the neutral zone was studied in hereditary and acquired dyschromatopsias. Acquired type III blue-yellow defects with neutral zone occurred in heredo-atrophies of the optic nerve, in edematous maculopathies, in choroidal atrophy, in myopia, in glaucoma and in retinitis pigmentosa. With exclusion of the autosomal dominant inherited cases, the type III neutral zone in retinitis pigmentosa becomes complicated by a type I neutral zone when the visual acuity dropped to 0.2.
In clinical routine EOG we are dealing with a base line or lightinsensitive potential and a lightsensitive potential, the latter consisting of at least two different oscillations, a fast negative and a slow positive one. Any judgement of EOG without referring to the absolute level of the baseline is an incomplete one. It is no longer justified to refer to the Arden ratio as a unique parameter for EOG normalty or abnormalty. Our knowledge about the generating mechanisms of the different EOG components is insufficient. Clinical EOG examination is one way to better understanding. Statistical evaluation is not easy because of the considerable inter- and intraindividual variations. The study of uniocular diseases or affections may solve some of our problems.
In general the statements in the manual of the New Color Test are confirmed, but there is no exact correlationship between the AOH-R-R classification and the NCT classification. There is a gradual increase in sensitivity from the AOH-R-R, via the panel D-15 and the NCT 6/2 to the desaturated panel 8/2. Thus, if the panel 8/2 result is normal the NCT 6/2 yields no further information.
The desaturated 15 Hue test is estimated to give about 7% false-positive single protanopic confusions. Confusions between tetartanopic and protanopic directions are not infrequent. The New Color Test findings, in general, reflect the AOH-R-R pathology but, among other things, because of the difference in their size, the classifications of both tests should not be compared. The New Color Test proves to be valuable, and can be easily employed in a routine clinical procedure. An examination scheme is proposed.
Dominant cystoid macular dystrophy (D.C.M.D.) is characterized by a macular dystrophy but at the same time by a pigmentary dystrophy of the retinal periphery. Ultimately D.C.M.D. resembles an atypical pigmentary dystrophy, in some cases that of a pericentral retinitis pigmentosa. In an early stage the results of the EOG and darkadaptation curve reflect the process at the level of the peripheral retina, while only in a late stage we may expect some diffuse ERG pathology. D.C.M.D. might be classified as a tapetoretinal dystrophy and in particular as a form of retinitis pigmentosa with an atypical visual disturbance and an atypical fundus appearance (Leber, 1871). In doing so attention is paid to the fact that D.C.M.D. is more than a macular dystrophy. The denomination of the disease as D.C.M.D. reflects the most important features at a relatively young age.
Peripheral cone disease is characterized by an absent cone function as measured by the ERG but a normal or slightly affected colour vision. The authors examined 20 cases. The most striking fact was the high incidence of myopia and the presence of nystagmus; on the basis of this finding the authors suggest that at least some cases of peripheral cone disease are due to myopic choroido-retinal degeneration (in French: "choroïdose myopique").
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Dominant cystoid macular dystrophy (DCMD) occurred in 28 members of 5 unrelated families. The disease is characterized by cystoid macular oedema and leakage from retinal capillaries in the posterior pole. Colour vision examination reveals a type I red-green defect with concomitant blue-yellow defectiveness; the latter may be caused by the leaking capillaries. The ERG is normal. The EOG is subnormal. Darkadaptation curves are often slightly disturbed. There are frequently also aspecific pigmentary alterations in the peripheral fundus.
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Since Goodman and coll. introduced the concept of cone dysfunction syndromes, many papers have been published. Some authors based their diagnosis on functional data while others referred to the classic denominations. As a consequence there is no uniformity with regard to terminology of the cone dystrophies. In an effort to avoir the introduction of new terms the author presents a classification of cone dysfunctions based on the results of electroretinography and color vision examination. This classification is dynamic since it allows the follow-up of a cone dystrophy into its late stages.